FINDINGS FROM THE RECOVERY CENTER OUTCOME STUDY

2020 F I N D I N G S AT A G L A N C E

Suggested citation: Logan, T., Cole, J., Miller, J. & Scrivner, A. (2020). Findings from the Recovery Center Outcome Study 2020 Find-ings at a Glance. Lexington, KY: University of Kentucky, Center on Drug and Alcohol Research.

INTRODUCTION

Recovery Kentucky was created to help Kentuckians recover from substance abuse, which often leads to chronic homelessness. There are currently 18 Recovery Kentucky centers across the Commonwealth, providing housing and recovery services for up to 2,200 persons simultaneously. Recovery Kentucky is a joint effort by the Kentucky Department for Local Government (DLG), the Department of Corrections, and Kentucky Housing Corporation. Local governments and communities at each Recovery Kentucky center location have also contributed greatly to making these centers a reality.1 The overall program is composed of 4 main components through which clients advance:

The Behavioral Health Outcome Studies team at the University of Kentucky Center on Drug and Alcohol Research (UK CDAR) independently conducts the Recovery Center Outcome Study (RCOS) which is an annual outcome evaluation that includes 17 of the18 of the Recovery Kentucky centers that participated in RCOS this fi scal year. Recovery center staff conduct an intake interview when clients enter Phase I after completing SOS and MT 1 and 2 to assess behaviors and problems clients had prior to entering the recovery center. Follow-up interviews are then conducted over the telephone by an interviewer at UK CDAR with eligible, consenting RCOS clients 12 months after Phase 1 entry. A random sample of eligible clients, stratifi ed by target month (based on the intake month), and gender was selected. Client responses are kept confi dential to help facilitate the honest evaluation of client outcomes and program services.

This Findings at a Glance report summarizes outcomes for 284 men and women who participated in a Recovery Kentucky program, completed a Phase 1 intake interview between July 2017 and June 2018 and a follow-up interview between July 2018 and June 2019. At intake, most clients included in this report were White (92%), not currently married or cohabiting (79%), predominately female (53%) and, on average, 34 years old.

1 For more information about Recovery Kentucky, contact KHC’s Mike Townsend toll-free in Kentucky at 800-633-8896 or 502-564-7630, extension 715; TTY711; or email MTownsend@kyhousing.org.

SAFE, OFF-THE-STREET (SOS)

Introduces the client to the program and sober

living through a supportive environment, including peers

who are in recovery.

MOTIVATIONAL TRACKS (MT 1 AND 2)

Assessments are made on the client’s motivation to

change their behaviors and attitudes by participating in educational classes and AA/

NA meetings.

PHASE 1

Includes learning responsibility and accountability to the overall community and environment as well as

completing classes on working the 12 steps of Alcoholics

Anonymous.

PHASE 2

Clients may become employed or become Peer

Mentors to others who are entering the recovery

center.

INTAKE ASSESSMENT FOR OUTCOME EVALUATION

For those who decide to go into Phase I AND agree to participate

in UK CDAR follow-up

2842,074

FOLLOW-UP ASSESSMENT FOR OUTCOME EVALUATION

12 months after program intake

4,490 3,968 1,550

FACTORS EXAMINED AT INTAKE AND FOLLOW-UP

Past-6-month substance use2

at intake86%

at follow-up14%

REPORTED ANY ILLEGAL DRUG USE***

REPORTED ANY ALCOHOL USE***

2 Fifty-fi ve individuals were not included in the analysis of change in substance use from the 6 months before entering the recovery center to the 6 months before follow-up because they reported being incarcerated the entire period measured at intake (n = 53), and they were incarcerated the entire period before follow-up (n = 2).3 Misuse of opioids other than heroin, including prescription opiates, methadone, and buprenorphine-naloxone.

at intake63%

at follow-up7%

REPORTED OPIOID USE***3

at intake41%

at follow-up3%

REPORTED HEROIN USE***

4 Amphetamine, methamphetamine, ecsctacy, Ritalin.

REPORTED ALCOHOL INTOXICATION***

REPORTED BINGE DRINKING***

at intake58%

at follow-up4%

REPORTED STIMULANT USE***4

How much has opioid and methamphetamine use changed over time?

100%

0%

90%

80%

70%

60%

50%

40%

30%

20%

10%

PRESCRIPTION OPIATES/OPIOIDSMETHAMPHETAMINE

HEROIN

METHADONE

BUPRENORPHINE-NALOXONE

This trend analysis examines the percent of RCOS clients who reported misusing prescription opiates/opioids, non-prescribed methadone, non-prescribed buprenorphine-naloxone (bup-nx), heroin, and methamphetamine in the 6 months before entering the program from FY 2010 to FY 2018.

at intake44%

at follow-up7%

at intake39%

at follow-up4%

at intake38%

at follow-up4%

Rx

FY2010 FY2011 FY2012 FY2013 FY2014 FY2015 FY2016 FY2017 FY2018

Past-6-month mental health

MET STUDY CRITERIA FOR

DEPRESSION***

MET STUDY CRITERIA FOR

ANXIETY***

MET STUDY CRITERIA FOR COMORBID DEPRESSION

& ANXIETY***

REPORTED SUICIDAL IDEATION AND/OR

ATTEMPTS

Trends in depression and/or generalized anxiety

The percent of clients meeting criteria for depression or generalized anxiety in the 6 months before entering the recovery center has fl uctuated from a little less than three-fourths (72%) to 87% over the past six fi scal years. Each year there has been a signifi cant decrease from intake to follow-up in the number of clients reporting either depression or generalized anxiety – with the lowest percentage at follow-up in FY 2015 (7%) and the highest in FY 2018 (25%).

Past-30-day physical health

AVERAGE NUMBER OF DAYS MENTAL HEALTH

WAS NOT GOOD***

AVERAGE NUMBER OF DAYS PHYSICAL HEALTH WAS NOT

GOOD***

REPORTED CHRONIC PAIN***5

5 Past-6-month measure.

at intake66%

at follow-up16%

at intake72%

at follow-up20%

at intake59%

at follow-up12%

at intake29%

at follow-up3%

72%81%

87%79%

84%79%

17% 18%

7%13%

21% 25%

FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Intake Follow-Up

at intake7.7

at follow-up3.1

at intake16.2

at follow-up3.7

at intake30%

at follow-up18%

Past-6-month economic indicators

EMPLOYED AT LEAST ONE MONTH***

Trends in employment by genderSince FY 2011, a disparity in employment between men and women in the RCOS follow-up sample has been evident.

Men Women

INTAKE FOLLOW-UP

GENDER WAGE GAP

$1.00 $0.77

At follow-up, employed women made only $0.77 for every dollar employed men made.

REPORTED DIFFICULTY MEETING HEALTH CARE

NEEDS***

REPORTED DIFFICULTY MEETING BASIC LIVING

NEEDS***

CURRENTLY HOMELESS***

at intake45%

at follow-up82%

59% 61%56%

60% 60% 57% 58% 58%

50%

38% 38% 37%

48%

37% 38%34%

FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18

77% 78% 81% 80%89%

78%85% 85%

55%

71% 73% 73% 71% 74%80% 79%

FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18

at intake35%

at follow-up10%

at intake43%

at follow-up20%

at intake25%

at follow-up13%

Trends in self-reported homelessness

In the past 6 fi scal years, the percent of people reporting homelessness at intake has increased slightly. From intake to follow-up, the percent reporting homelessness has decreased each year.

Past-6-month criminal justice involvement

REPORTED ANY ARREST***

REPORTED BEING INCARCERATED***

Trends in arrestsOver the past 6 years, over half of RCOS clients reported being arrested at least once in the past 6 months. Each year, at follow-up, signifi cantly fewer clients reported an arrest in the past 6 months.

REPORTED CRIMINAL JUSTICE SUPERVISION***

28%35% 38% 38% 38% 35%

11% 8%2% 2% 5%

10%

FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Intake Follow-Up

6’0”

5’0”

4’0”

4’6”

5’6”

3’0”

3’6”

at intake60%

at follow-up11%

at intake78%

at follow-up15%

at intake79%

at follow-up61%

54% 52% 52%56% 58% 60%

7% 7%1% 3%

8% 11%

FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018

Intake Follow-Up

Past-6-month defi cits in recovery capital resources

The multidimensional recovery index uses items from the intake and follow-up surveys to create one index that can be used to classify individuals who have better or worse status at follow-up. The index includes: having no substance use disorder, being employed full-time or part-time, not being homeless, having no arrests or incarceration, having no suicidal thoughts or attempts, having fair to excellent health, having recovery support, and having a mid to high quality of life.

MULTIDIMENSIONAL RECOVERY

INDICATING BETTER STATUS***

Recovery supports

REPORTED ATTENDING MUTUAL HELP

RECOVERY MEETING IN THE PAST 30 DAYS ***

faith or religion

49%faith or religion

21%support from

others in recovery

37% 20%support from family, friends,

partner

27%self-help recovery meetings

30%

WHAT WILL BE MOST USEFUL IN STAYING OFF DRUGS/ALCOHOL AT INTAKE AND FOLLOW-UP

INTAKE FOLLOW-UP

RETURN ON INVESTMENT IN RECOVERY CENTER SERVICES

Estimates of the cost per drug user and alcohol user were applied to the sample to examine the total costs of drug and alcohol abuse to society in relation to expenditures on the Recovery Kentucky program. The cost savings analysis suggests that for every dollar invested in recovery services there was an estimated $2.25 return in avoided costs (i.e., costs to society that would have been expected given the costs associated with drug and alcohol use).

Overall, Recovery Kentucky program clients made signifi cant strides in all of the targeted areas and have much more support for their recovery after participating in program services.6 In addition, the Recovery Kentucky Program saved taxpayer dollars through avoided costs to society or costs that would have been expected based on the rates of drug and alcohol use.

CONCLUSION

6 It is important to keep in mind that the RCOS sample includes only clients who advanced to Phase 1 after completing the SOS and Motivational Tracks and who agreed to be contacted for the follow-up survey 12 months after entering Phase I.

COST-SAVINGS FOR TAXPAYERS

$2.25ESTIMATED

at intake38%

at follow-up78%

support from family, friends,

partner

at intake0%

at follow-up59%